Guzman was an inmate in a Harris County jail who hanged himself, while jailers watched YouTube videos and ate pizza. His body wasn’t found until almost an hour after he was supposed to have been checked on.

“We’ve seen over the last five or six years, about 150 people dying in Texas jails and many of them haven’t been convicted of any crime,” Barned-Smith says.

According to Barned-Smith, the majority of suicides occur by hanging – usually with clothing, shoelaces, or linens. A small number attempt various other methods, like overdosing on medication.

In the case of Guzman, Barned-Smith says that only one of the Harris County jailers had taken a suicide prevention class. The intake process for inmates already includes a chance to identify whether a person is at-risk for suicide, but the screening typically consists of one short, single-page questionnaire.

“The people who are doing it, they’ll receive special training. Sometimes, it’s a health professional. But often times, it’s just a jailer with not very much experience,” Barned-Smith says.